Public Health – how partnership with industry can work
By Richard Vize, Public Policy Media Ltd
Public health is not yet occupying the space envisaged for it under the Coalition government’s health reforms. Then health secretary Andrew Lansley’s vision was to remove ministers from day-to-day running of the NHS while greatly increasing the Department of Health’s focus on public health. Before the election the Conservatives even floated the idea of renaming the DH the Department of Public Health.
Jeremy Hunt is instead micromanaging the NHS and giving far less emphasis to the work of Public Health England. Meanwhile public health directors are doing what all good local government managers should do, and focusing on the needs of their local area. Many are relishing their new freedom outside the centralised NHS. So what is the role for the centre in improving public health?
The Cambridge Health Network’s discussion on public health underscored what could be achieved with an ambitious public health policy, but also provided evidence that the Coalition’s approach of partnering with food and drink manufacturers to improve public health is leading to at least some modest achievements.
The quiet passion of Public Health England chief executive Duncan Selbie’s presentation brought home the overwhelming importance of personal choices and environment in determining how we live and die, compared with the public’s perception of the central role of NHS services.
His ambition was clear, such as taking smoking “off the pitch” and wanting every party manifesto in the next general election to be arguing for investment in what really makes a difference.
He also mounted a robust defence of councils’ ability to make a success of its new role, highlighting the passion for improving the health of their communities, and how public health is playing a role in the sometimes life-changing Troubled Families Programme.
Selbie urged health professionals to have a degree of humility, and understand the need to work with others such as industry and schools to bring about sustainable improvements in the public’s health.
The right balance between regulation of the food, drink and tobacco industries and working in partnership with them has been the most contentious part of the public health reforms. Lansley always made clear that he favoured a “new responsibility deal between government and business, built on shared social responsibility and not state regulation”.
Fiona Dawson, president of Mars Chocolate UK, personifies what he had in mind. She admitted to the seminar that her company had been “blindsided” when climbing obesity rates first gripped the public consciousness in 2004. But by 2005 the company had decided to take an active role in the debate, including making changes to its products.
She also convinced many in the audience that her firm looks after its staff rather better than many NHS organisations, who should surely be exemplars of public health collaboration for their own workforce.
Dawson gave an assured description of how partnership with industry can work, but the question remains as to how widespread that partnership is extending, whether the changes it is securing are enough to make a difference, and whether regulation still has a role to play in compelling improvements.